Ontario’s Flawed Mental Health System and the Failure of the Current Provincial Government

I recently came across an excellent assessment of the very bad mental health system in Ontario that prefers to have people receive services in the forensic stream rather than before they get to that point. The assessment was not published but was obtained under Freedom of Information.

After that appeared, the Hamilton Spectator did a feature on a young man named Ross Biancale with the head I’ve already written his obituary: Mom struggles to save son from himself. This sad but true recounting of what it takes to get someone service in Ontario illustrated all the points that I made in my Huffington Post blog. Below is my explanation for this mess.

The reason that Ross Biancale and thousands like him are falling through the cracks of the mental health system (the Spectator, January 23) is easily explained and easily fixed. They have not been fixed because the Liberal government has no interest in doing so.

Justice Schneider points out that the main fault is the Ontario Mental Health Act and the conditions required for an involuntary committal to hospital. Under the current legislation, someone who is exhibiting all the signs of illness, listening to the voices of Martians in his head while denying he is ill, cannot be hospitalized without consent. Neither the police nor the Justice of the Peace will help hospitalize that person if they do not believe there is “clear evidence that he is dangerous to himself or others”. And, even if he is admitted, he is “discharged before he is stable” and “his condition deteriorates”.

Justice Schneider said “if the individual is not seen as dangerous to himself or others he is free to roam the streets ‘madder than a hatter’” And, in many cases, the person will come into conflict with the law and wind up in the vastly more expensive forensic psychiatric system.

The 1967 Ontario Mental Health Act allowed for someone to be admitted to hospital involuntarily if they were suffering from a mental disorder severe enough to warrant treatment in hospital for their own or others safety and they could be held for one month. That was changed in 1978 thanks to the civil libertarians to involuntary treatment only if the person had threatened or attempted to do harm to himself or others. The time held was lowered to 14 days.

Further, the 1967 Act considered that hospitalization meant treatment and people being held were treated. That changed in 1978 and someone could be held involuntarily but they did not have to agree to treatment.

Attempts have been made to change the Mental Health Act in Ontario and that was one of the recommendations of the 2008 all party Select Committee on Mental Health and Addictions. Recommendation 21 in that report states that the Ontario government should set up a task force within one year to “investigate and propose changes to Ontario’s mental health legislation and

policy pertaining to involuntary admission and treatment.”

That was 2008 and this is 2018 and the Liberal government still has not acted.

The other barrier to effective treatment mentioned in the Spectator article is our privacy legislation. If a person is over 18, they are an adult even if they live with their parents and are supported by them. Health care providers cannot talk to family without the permission of the ill person and, if they are paranoid, they may not grant permission.

The Select Committee also decided that the government should change the privacy legislation in recommendation 22. “The changes”, they said, “should ensure that family members and caregivers providing support to, and often living with, an individual with a mental illness or addiction have access to the personal health information necessary to provide that support, to prevent the further deterioration in the health of that individual, and to minimize the risk of serious psychological or physical harm.”

The 2013 Mental Health Commission of Canada report on caregivers made similar recommendations but, again, this is 2018 and Ontario has still done nothing.

These are issues that those of us with an interest in improved care for the mentally ill need to ask the candidates running in the upcoming provincial election.

6 thoughts on “Ontario’s Flawed Mental Health System and the Failure of the Current Provincial Government”

Thank you for telling of us the major flaws in the Ontario Mental Health Act. The flaws are obvious. We see the consequences on all of our main streets in Ontario. daily

Yet a group in B.C sees our Ontario Act as a model and is trying to get their somewhat better ACT overturned using our Ontario great model as the thing to strive for For Pete’s sake it is no example to follow. More on this subject later. Those with serious diagnoses who are stable will not thank the BC government if it should enter into such folly. !

The fact that criminalization of serious mental illness happened in Canada as well as its southern neighbor is very discouraging to those who admire Canadian healthcare. As the old saying goes, “The problem isn’t ignorance, it’s the illusion of knowledge.”
In the 1970’s, as Chief Psychologist of the US Bureau of Prisons, I was personally and professionally in the middle of the U.S. shift from mental healthcare to forensic responsibility for those suffering from serious mental illness. At that time, both systems could be said to based on the containment model. Mental health hospitals were alternative housing at best and horrific abuse at worst. But my perception of the pivotal cultural shift was it was due to new research that showed mental health clinicians were terrible predictors of dangerousness. Instead of refining the criteria for need for treatment, clinicians deferred to the lawyers who insisted on focusing on refining the criteria for dangerousness. Hence, “imminent danger.”
Mental health professionals took the easier softer way of abdicating responsibility for people with SMI who don’t beg for help, don’t act nice, don’t talk nice, don’t smell nice. Those unfortunates are now sent to homelessness, jail/prison or death.

Astounding how the psychoanalytical culture spread ignorance across the globe like wildfire. The misconceptualization of psychosis as psychological is what underlies this illogic. That faction is still proselytizing their trauma/abuse and now epigenetics theories even today and denying the biological construct of SMI. When you get the nature of the illnesses wrong – you get public policies wrong! duejusticeproject.net

I’m sick and tired about the trumpeting of rights for the mentally ill. Everyone disregards the rights of the friends and family who suffer, the 2 kids whose father hung himself, the father who cut his son done hanging from his shed, the countless who can;t get help due to misguided rights, the vast amounts of money, hundreds of hours of time, countless sleepless nights suffered in vain while people die. Is it to prop up an industry which fails before it starts due to the right to refuse help even at the age of 12? I sincerely pray that all who defend the right of the mentally ill to refuse help live in my world and share in the agony of utter helplessness and angst.

The Mental Health System in my city of Windsor, Ontario, Canada, has been an absolute, appalling failure on all counts. I could have done better with the Budget they had, And I am Homocidal/Suicidal Rapid Bipolar Cycling..Depressed, Manic, OCD and Borderline Personality Disorder.
The best I ever got was short stays in the Psych Ward, then kicked out on my ass, when I was still Suicidal!!